Identifying Novel Inhibitors of Workplace Support and the Importance of Value Congruence and Feeling Valued in General Surgery Residency Training

OBJECTIVE: To explore residents' perceptions of workplace support inhibitors and their relationship to resident wellbe- ing. We aim to provide evidence -based targets to inform future work operationalizing support in surgical training. DESIGN: This is a 2 -part mixed -methods cross-sectional study. Part 1 analyzed qualitative data from focus groups (April 2021 -May 2022). Part 2 comprised an online sur- vey (informed by findings in Part 1, May 2022) to assess the association between perceived workplace support (e.g. feeling valued and value congruence) and poor indi- vidual global wellbeing (e.g. languishing). SETTING: National multi -center study including 16 ACGME-accredited academic programs. PARTICIPANTS: General surgery residents at all training levels, both clinical and research years. RESULTS: 28 residents participated in the focus groups which revealed three major themes around perceived inhibitors of workplace support: lack of trust in resi- dency program (e.g. ulterior motives), poor communi- cation from leadership (e.g. lack of transparency, ineffective dialogue), and unfair systems in residency training (e.g. exploitation of residents, paternal leave policies). These themes emphasized the importance of feeling valued and value congruence, with the latter reflected in the form of trust and communication with leadership, a key element of worker -workplace align- ment. 251 residents responded to the survey (response rate 31%, 50.6% women) which revealed that a lower sense of feeling valued and lower perceived value con- gruence were significantly associated with languishing. CONCLUSIONS: Our findings suggest feeling valued and value congruence (specifically, having trust and commu- nication with leadership) are important targets for increasing workplace support in surgical training, offer- ing evidence -based targets for future work to operation- alize support in surgical training. ( J Surg Ed 81:804 - 815. (c) 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)